Chronic pain is a significant public health concern. Care for patients with chronic pain is complex and involves many intersecting systems, policies, and procedures. Applying systems engineering concepts to chronic pain management opens the door to addressing a wide range of performance gaps through a structured, evidence-based approach. Successful implementation of systems-based practice includes effectively incorporating interprofessional teamwork, community resources, team-based care, patient safety, hospital readmissions, use of evidence-based medicine, transitions of care, and care for the underserved, including social determinants of health into the routine delivery of health care services including pain management.